Archives of Breast Cancer
Year:2019 | Volume:6 | Issue:4|Papers Count:7

The treatment of breast cancer is changing so much so that a recent JAMA 2019 editorial Breast Cancer Treatment did not even mention surgery or radiotherapy in the article. 1 The management protocols change regularly making multidisciplinary management mandatory. . . .

Oncoplastic breast surgery (OBS) has been a breakthrough in the surgical management of breast cancer. Evolving and improving within recent decades, it might be time to reassess this novel technique to discuss who would be responsible for applying these techniques. Within many centers in the North America, a team of oncologic and plastic surgeons collaborates in performing oncoplastic breast surgeries together, whereas, in European cancer centers, breast surgeons are generally responsible for both oncologic and oncoplastic procedures. So in this letter, the benefits and the disadvantages of each approach are discussed. . . .

Background: The effect of exogenous sex hormones on the risk of breast cancer has been shown for some compounds but for other compounds it is under detailed investigation. This study, as part of a quadruple of articles reviewing the consequences of using sex hormones in women with various breast conditions, discusses the prescription of non-oral hormonal contraceptives and miscellaneous exogenous steroid hormones. Method: We browsed international clinical guidelines and carried out a comprehensive search in the literature by relevant keywords in order to extract data about the effects of hormone-releasing intrauterine devices, injectable depotmedroxyprogesterone acetate, contraceptive implants, cyproterone acetate, finasteride, and spironolactone on the breast. Results: Studies are scarce for most of these compounds, and information comes mainly from researches about oral contraceptives and hormone replacement therapy. Although none is recommended for use in patients with breast cancer, administration in benign disorders of the breast, women with positive family history of breast cancer and general women is acceptable with minor risks. Conclusions: Most non-oral hormonal methods of contraception and miscellaneous available hormone compounds prescribed for the treatment of hormonal disorders are safe for temporary use, except for women with breast cancer. For them, analogues of gonadotropin-releasing hormones may be considered a safe hormonal prescription.

Background: There are several therapeutic options available for breast cancer treatment, now incorporating innovative targeted molecular therapies. Metastatic breast cancer is usually treated with chemotherapy and/or hormonotherapy. Surgery has not been shown to improve survival. Adjuvant radiotherapy (RT) has been proven to be effective in the treatment of locally advanced breast cancer, reducing locoregional recurrence. The optimal treatment of internal mammary lymph nodes (IMN) metastases remains controversial. Case presentation: A 48-year-old woman was diagnosed with invasive breast cancer with ipsilateral metastases to axillary lymph nodes and a contralateral IMN metastasis. This case was presented twice during the tumor board sessions of the Surgical Oncology Service at the Centre hospitalier de l'Universite de Montreal (CHUM), Montré al, Canada. Question: Does the internal mammary chain (IMC) dissection could be used as a treatment approach in breast cancer with IMC metastasis? Conclusion: Internal mammary chain dissection should be discussed in tumor board sessions on a case-by-case basis. There are no strong guidelines on the management of IMN metastasis in breast cancer, but there is growing evidence that these women should be treated with curative intent.

Background: To determine the relationship between color and spectral Doppler features of breast cancers and their biomarkers. Methods: From January 2017 to January 2018, 43 patients with breast cancer were enrolled. Age, the existence of color flow in the Doppler ultrasound, color flow pattern, tumor size, and immunohistochemistry (IHC) subtypes were recorded. Results: Among 43 breast cancer patients, IHC profiles showed that 36 patients were estrogen receptor (ER) positive, 30 patients were progesterone receptor (PR) positive, and 12 patients were human epidermal growth factor receptor 2 (Her-2) positive. The prevalence of biomarker groups in this study were as follows: luminal A, 21 patients (48. 83%); luminal B, 15 (34. 88%); Her-2 amplifiers, 2 (4. 65%); and triple negative, 5 (11. 62%). Thirty-seven patients (86. 04%) with malignant masses had detectable flow and six patients (13. 95%) had no detectable flow. The ER-positive and PR-positive breast cancers had the highest vascular presence rate in color Doppler ultrasound, but it was not statistically significant. Maximum vessel diameter in the difference biomarker groups and Doppler color patterns with various biomarkers showed no significant the differences. Conclusion: Based on the results of this article, we could not predict the breast cancer biomarker groups using available Color Doppler features and indexes, so pathology with IHC is still required.

Background: This study aimed to investigate the effectiveness of short-term group logo-therapy on life expectancy and resilience of women with breast cancer. Methods: This applied study is quasi-experimental and was designed by the use of pre-test and post-test. The population of study included all women with breast cancer, from which 30 women with breast cancer were randomly divided into experimental and control groups. To collect study data, The life expectancy scale and Connor-Davidson Resilience Scale (CD-RIS) were used. For data analysis, covariance analysis ANCOVA was used. Results: The results showed that there is a significant difference between the scores of life expectancy between groups F= 485. 012, p= 0. 005 and there is a significant difference between the mean scores of resilience among groups F= 2. 051, P= 0. 001. Conclusions: In general, it can be said that, group logo-therapy can help women with breast cancer to find meaning in their life, receive support from groups, and adapt themselves with diseases. Also, logo-therapy can be useful in breast cancer patient’ s attitude towards hardships and problems and can increase their strength and resilience.

Background: This study aimed to translate and validate the Fear of Cancer Recurrence Inventory (FCRI) questionnaire into Persian and to investigate its psychometric properties. Methods: The FCRI was translated to Persian using a linguistic methodology according to WHO guidelines. A total of 450 breast cancer survivors who had the following inclusion criteria were included: time elapse of more than six months after the treatment prior to the study; absence of objective markers of recurrence, fluency in the Persian language, and signing the informed consent. Internal consistency was estimated with Cronbach's α coefficient and test-retest reliability with Interclass correlation. Concurrent validity was estimated through Pearson’ s correlation between the FCRI and Hospital Anxiety and Depression Scale (HADS). Principal component analysis (PCA) and confirmatory factor analysis (CFA) were employed to evaluate dimensionality. Results: The Persian version was acceptable for patients. The content validity index (CVI) was 0. 80. The instrument had good test-retest reliability (ICC= 0. 96) and internal consistency (Cronbach’ s α =0. 86). PCA and CFA indicated that the factor structure of the Persian version was similar to the original questionnaire and had acceptable goodness of fit. Correlations between the FCRI and HADS was remarkable (r= 0. 252 – 0. 639), indicating acceptable concurrent validity. Conclusions: The Persian version of FCRI could be considered a good crosscultural equivalent for the original English version. The questionnaire was a reliable and valid instrument in terms of internal consistency, test-retest reliability, and dimensionality.